Retrospective evaluation of clinical profile and comorbidities in patients with alopecia areata

OBJECTIVE: The aim of the study was to determine the clinical profile of the patients with alopecia areata (AA) and whether or not any differences between the AA patients with and without comorbidity.
METHODS: A total of 218 patients diagnosed with AA between January 1, 2016, and August 31, 2020, in our outpatient clinic were analyzed retrospectively.
RESULTS: The mean age was 27.8±12.3. 61.5% of the patients were male (M/F=1.59). There were AA in 96.3%, alopecia universalis in 3.2%, and alopecia totalis in 0.5% of the patients. Most of them showed unifocal involvement (85.8%) and multifocal involvement to a smaller extent (10.5%). Number of patches was 1 in 75.2%, 2 in 16.7% and 3 or more in 8.1% of AA patients. Average disease duration was 18.1 months. Comorbid diseases were accompanying to 51.8% of the patients. Dermatological diseases were among the most common accompanying diseases (17.9%). However, hypothyroidism (12.8%) was the most frequent comorbid disease. There were thyroidal diseases in 15.1%, allergic disorders in 7.7%, psychiatric disorders in 7.3%, anemia in 5.9%, rheumatic diseases in 2.2%, other endocrine diseases in 1.8%, malignancy in 1.3%, and morbid obesity in 1.3% of the patients. Down syndrome accompanied in 0.9%. Vitamin-D deficiency (38.9%), low ferritin (13.8%), and B12 deficiency (9.6%) were also detected. Female gender (46.9 to 29.5%, p=0.008), extensive disease (p=0.085), Vitamin B12 deficiency (13.3 to 5.7%, p=0.059), and low ferritin level (20.4 to 6.7%, p=0.003) were observed more in patients with comorbidity than those without one.
CONCLUSION: AA accompanies various systemic, autoimmune, and psychiatric diseases. Dermatologists need to recognize potential comorbid diseases, evaluate and manage these patients with a multidisciplinary approach to achieve a better outcome.

Alopesi Areata Hastalarýnda Klinik Profil ve Komorbid Hastalýklar

AMAÇ: Çalýþmanýn amacý, alopesi areata (AA) hastalarýnýn klinik profilini ve komorbiditesi olan ve olmayan AA hastalarý arasýnda fark olup olmadýðýný belirlemekti.
GEREÇ VE YÖNTEM: Polikliniðimizde 1 Ocak 2016 ile 31 Aðustos 2020 tarihleri arasýnda AA tanýsý alan 218 hasta retrospektif olarak incelendi.
BULGULAR: Ortalama yaþ 27,8 ± 12,3 idi. Hastalarýn %61,5'i erkekti (E / K = 1,59). Hastalarýn %96,3'ünde AA, %3,2'sinde A.universalis ve %0,5'inde A.totalis vardý. AA hastalarýnýn %85,8'inde unifokal, %10,5'inde multifokal tutulum mevcuttu. AA hastalarýnýn %75,2'sinde 1, %16,7'sinde 2 ve % 8,1'inde 3 veya daha fazla yama mevcuttu. Ortalama hastalýk süresi 18,1 aydý. Hastalarýn %51,8'ine komorbid hastalýklar eþlik ediyordu. Dermatolojik hastalýklar en sýk görülen hastalýklardý (%17,9). Ancak %12,8 ile hipotiroidizm en sýk görülen komorbid hastalýktý. Hastalarýn %15’inde tiroid hastalýklarý, %7,7’inde alerjik bozukluklar, %7,3’inde psikiyatrik bozukluklar, %5,9’inde anemi, %2,2’inde romatizmal hastalýklar, %1,8'inde diðer endokrin hastalýklar, % 1,3'ünde malignite,% 1,3'ünde morbid obezite vardý. Down sendromu %0,9 oranýnda eþlik ediyordu. Hastalarýn %38,9’inde D vitamini eksikliði, %13,8’inde düþük ferritin düzeyi, %9,6’sýnda B12 eksikliði vardý. Kadýn hasta (% 46,9 ila 29,5, p = 0,008), yaygýn hastalýk (p = 0,085), B12 vitamini eksikliði (% 13,3 ila 5,7, p = 0,059) ve düþük ferritin düzeyi (20,4’e % 6,7, p = 0,003) komorbiditesi olan AA’lý hastalarda olmayanlara göre daha yüksekti.
SONUÇ: AA çeþitli sistemik, otoimmün ve psikiyatrik hastalýklara eþlik etmektedir. AA'da daha iyi sonuç elde etmek için dermatologlarýn olasý komorbid hastalýklarý tanýmasý, bunlarý multidisipliner yaklaþýmla deðerlendirmesi ve tedavi etmesi gerekir. (NCI-2021-11-9/R1)